| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VERUS INSURANCE SERVICES, LLC3 | 6085 DOUGLAS BLVD., SUITE 400 GRANITE BAY, CA 95746 | KAISER FOUNDATION HEALTH PLAN INC. | $21K | — | $21K | 4.60% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | P.O. BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN INC. | $7K | $961 | $8K | 1.69% |
| VERUS INSURANCE SERVICES, LLC3 | 6085 DOUGLAS BLVD., SUITE 400 GRANITE BAY, CA 95746 | UNITED HEALTHCARE INSURANCE COMPANY | $22K | — | $22K | 5.02% |
| AMWINS3 Filed as: LISI, INC. | 1600 W. HILLSDALE BLVD. SAN MATEO, CA 94402 | UNITED HEALTHCARE INSURANCE COMPANY | $10K | — | $10K | 2.17% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | P.O. BOX 2158 RIVERSIDE, CA 92516 | UNITED HEALTHCARE INSURANCE COMPANY | $7K | — | $7K | 1.48% |
| VERUS INSURANCE SERVICES, LLC3 | 6085 DOUGLAS BLVD., SUITE 400 GRANITE BAY, CA 95746 | SUTTER HEALTH PLAN | $5K | — | $5K | 3.84% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | P.O. BOX 2158 RIVERSIDE, CA 92516 | SUTTER HEALTH PLAN | $2K | — | $2K | 1.16% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | P.O. BOX 2158 RIVERSIDE, CA 92516 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $477 | $2K | 2.09% |
| VERUS INSURANCE SERVICES, LLC3 | 6085 DOUGLAS BLVD., SUITE 400 GRANITE BAY, CA 95746 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | — | $2K | 1.83% |
| VERUS INSURANCE SERVICES, LLC3 | 6085 DOUGLAS BLVD., SUITE 400 GRANITE BAY, CA 95746 | COPOWER VSP | $2K | — | $2K | 8.44% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | P.O. BOX 2158 RIVERSIDE, CA 92516 | COPOWER VSP | $283 | — | $283 | 1.56% |
| VERUS INSURANCE SERVICES, LLC3 | 6085 DOUGLAS BLVD., SUITE 400 GRANITE BAY, CA 95746 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 10.85% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | P.O. BOX 2158 RIVERSIDE, CA 92516 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $601 | $294 | $895 | 5.09% |
| VERUS INSURANCE SERVICES, LLC3 | 6085 DOUGLAS BLVD., SUITE 400 GRANITE BAY, CA 95746 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | — | $1K | 11.35% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | P.O. BOX 2158 RIVERSIDE, CA 92516 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $393 | $182 | $575 | 5.35% |
| VERUS INSURANCE SERVICES, LLC3 | 6085 DOUGLAS BLVD., SUITE 400 GRANITE BAY, CA 95746 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $800 | — | $800 | 8.87% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | P.O. BOX 2158 RIVERSIDE, CA 92516 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $303 | $150 | $453 | 5.02% |
| VERUS INSURANCE SERVICES, LLC3 | 6085 DOUGLAS BLVD., SUITE 400 GRANITE BAY, CA 95746 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $766 | — | $766 | 8.85% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | P.O. BOX 2158 RIVERSIDE, CA 92516 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $295 | $145 | $440 | 5.08% |
| VERUS INSURANCE SERVICES, LLC3 | 6085 DOUGLAS BLVD., SUITE 400 GRANITE BAY, CA 95746 | LANDMARK HEALTHPLAN | $472 | — | $472 | 10.00% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 139 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 140 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 138 | $1.0M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 389 | $99K |
| Vision | COPOWER VSP | 110 | $18K |
| Life insurance(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 139 | $20K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 139 | $9K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 139 | $18K |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 138 | $1.0M |
| Other(4 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 250 | $42K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 389 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.